Determination of D-Dimer Value in Diagnosis of Atrial Thrombus in Patients with Atrial Fibrilation

Considering the and importance of formation of atrial Thrombus (AT) in patients who had developed atrial fibrilation (AF) and its early diagnosis, and with some regards to several reports on benefits of applying the D-Dimer test in such conditions, this study was carried out to detemine the accuracy and value of this test compared to the gold standard method of Trans-Esophageal Echocardiography (TEE) in patients referring to Modarres hospital. This clinical trial was performed on 73 patients whom were diagnosed as having AF. A more accurate method of TEE was applied to confirm if they had atrial thrombi. For determination of value of D-Dimer test in diagnosis of AT, 5 cc of blood was taken from any subjects. The results were regarded normal if the D-Dimer level was less than 500 ng/ml. Then positive and negative predictive values (PPV & NPV) were calculated as diagnostic measurments. Of the 73 subjects of this study (67% women versus 33% men) with mean age of 44.7±12 years old, there was 53.4% who had the history of Warfarin usage. According to the results of D-Dimer test, 33% had reached to positive levels, whereas 67% revealed to have no thrombus. The PPV of this test was calculated 48.6% and the NPV was 81.6%. Regarding the present condition of our patients and the excessive use of Warfarin among them and also probable failures of D-Dimer test, this test does not have the acceptible capability (particularly duringin these situations) in diagnosing AT.